Rock Climbing Injuries

Rock Climbing Injuries

Sammi Iannucci

Background:

Rock climbing injuries is an area that I am passionate about as a climber myself and a member of UNC’s climbing team. I am driven to help improve longevity in these athletes who are susceptible to injury if not informed on concepts such as proper training load and warmup. I am interested in working with this population in the future to help them rehab these injuries and return to climbing and there is a great opportunity emerging in physical therapy to work with this growing population. With this project I wanted to expand my knowledge base on climbing injuries including which are the most common, what causes them, injury risk factors, movement patterns that lead to injury, prevention, and rehabilitation.

Statement of Need:

Rock climbing is a rapidly growing sport that produces a variety of injuries, many of which are not commonly seen in other sports due to the unique demand climbing places on the upper extremity, particularly the fingers. It is also unique in the sense that many start the sport without formal training or coaching and may not have the knowledge to train in a manner that avoids preventable injuries. There is a need for climbers and those who treat climbers to gain a greater understanding of these injuries, their prevention, and rehabilitation, and how to safely return to climbing post-injury. Like many sports, rock climbing can become a lifestyle and result in a desire to push through injury. Knowledge specific to climbing injuries is necessary for both climbers and physical therapists to allow for optimal healing and return to sport.

Purpose:

With this project I wanted to combine rock climbing terminology and technique with anatomy/physiology, training principles, and current knowledge of rehabilitation methods. The audience was both PTs to learn about the unique demands of climbing and climbers to learn about preventing injury and understand the physiological side.

Products:

To accomplish this I consulted with my committee members who are PTs that currently treat climbers in the development of a PowerPoint that explains climbing demands in a more medical context. Based on what was found in the research to be the most commonly injured body region – the fingers – a large focus was on differential diagnoses for finger pain when climbing. I presented the PowerPoint to members of my climbing team after practice and shared the file with the rest of the members who were not able to make it that day. I will also be saving this PowerPoint as a resource that I can edit and add to for use in the future with climbing workshops at gyms or to pass along to other PTs who are interested in learning about treating the climber in their own practice. This initial version which was presented to climbers did not include many definitions of climbing terminology since they were familiar with that aspect of it, but if presenting to PTs I may add pictures and define types of climbing, how routes are graded for difficulty, explain basic climbing technique, etc.

I also put together an Evidence Table that included a look into the rehabilitation focused research I found to more thoroughly analyze what exactly they were looking at in these studies and identified practical climbing takeaways.

Self-Reflection:

I learned a lot about rehabilitating injuries of the fingers with this project. This is an area of the body that is less frequently treated by PTs typically but would be essential for the PT who treats rock climbers to master. I have definitely expanded my knowledge of potential diagnoses for finger pain and how to differentiate between them. What I most enjoyed about this project was the new perspective I gained for movement analysis and understanding of the physiological demands of specific components of rock climbing such as how different grips tax the muscles/tendons/pulleys. I also enjoyed seeing how climbing is now being utilized in the rehabilitation process to help these tissues recover in some of the research being done, rather than ceased all together. Although I found some of the return-to-sport protocols to be imprecise and not individualized enough for each climber, I appreciated taking the mindset of how to break down the sport into a graded return. For example, the Meyers protocol for return from epiphyseal fracture, manipulated the factors: number of training sessions per week, total training time of each session, climbing hold type (easier being larger holds with a positive edge), larger holds for feet, relatively vertical walls (versus steeper more overhung walls), and more static climbing (over dynamic powerful movements).⁹

Overall, I am pleased with what I have been able to accomplish with my project and am looking forward to future potential opportunities to continue exploring treatment of this population. During the course of this project, I was not able to shadow my mentor Chris Ball at his pro-bono climbing clinic at Triangle Rock Gym in Raleigh, but plan to do so in May which should be a great experience to see the treatment of these patients firsthand. Research in this field is very new and limited so I will continue to seek out the most current evidence for treatment approaches.

Acknowledgments:

I would like to thank my faculty advisor, Dr. Mike Lewek, PT, PhD for his support and guidance during the process of this project. I would also like to thank Todd Bushman, PT, DPT, CSCS and Chris Ball PT, DPT, CSCS for sharing their expertise working with rock climbers and providing me feedback along the way.

References:

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